The cannabis laced with fentanyl myth that just won’t die

Being someone who survived overdose & addiction and now works closely in response to the ongoing overdose crisis I hear devastating stories of loss all the time.  While all are heartbreaking, and attached to the understanding that virtually all fatal overdoses are preventable, not every story I’ve been told about overdose is accurate. 

One such story that continues to rear it’s ugly head is the myth that cannabis is being laced with fentanyl and killing unsuspecting consumers.

Unverified internet articles abound spewing anecdotal reactions from law enforcement and first responders.  An example of the garbage journalism that spreads this fear driven narrative is this recent article from WUSA9 that claims “Altered marijuana causing overdoses in northern Virginia, officials say”.  The headline does acknowledge that it’s just regurgitating something someone said, and the first paragraph clearly reveals that we are dealing only with speculation “believed a supply of the drug may have been mixed with unusual substances.”  What is most unfortunate is that the vast majority of the population will not read into the nuance of these words or look carefully for follow up articles that reveal actual lab results.

No documented cases

As we dig into this myth it is important to keep in mind that there are no documented cases of fentanyl contaminating marijuana.  People may tell the story, it may be repeated to news media but in the lab, police and experts analyzing seized drugs have yet to see this.

“Fentanyl hasn’t shown up in any marijuana seized by the Drug Enforcement Administration, the agency’s Jill Head, a senior chemist, confirmed in March 2019 at a National Drug Early Warning System briefing.” (Buzz Feed news)

Sensationalizing Fentanyl

Our neighbours to the south are not doing us any favors in terms of modernizing our social understanding and approach to drugs. The US media (not to ignore the frequently ignorant or complicit Canadian media that regurgitates these stories) often talks about fentanyl as a ‘weapon of mass destruction’ where seizures are described in terms of how many millions of citizens the drug could kill.  I don’t find this helpful.  Fentanyl is not a weapon and it’s not being weaponized.  It’s not laying around where any random person may stumble across it.  It’s not a new drug either.  Fentanyl was first synthesized in 1960 and has been used medically around the world since its approval.  An August 2018 CNN headline stated “law enforcement seize enough fentanyl to kill 14 million people” the amount: 30kg.  In 2015 over 1600kg of fentanyl were used in healthcare.  According to sensational media sentiment the headline should read “doctors administer enough fentanyl to kill 746 million people”, realistically doctors didn’t kill anyone, rather it served a valid medical purpose and helped millions of individuals. Fentanyl like all drugs can be used safely when the substance is of known quality & quantity, something street drugs do not offer. Fentanyl happens to be the most widely used synthetic opioid in medicine.

News media has created a panic around fentanyl.  People are afraid of fentanyl, and for good reason.  If you’re using illegal powders or pills obtained on the black market, you are at risk of an overdose.  Since the onset of the crisis (declared in BC, Canada in April of 2016)  Public Health officials and harm reduction advocates have been spreading the message far and wide: don’t use alone, get your drugs tested, have someone with naloxone standing by.  The drug supply is not what it once was, and we now live in a time where anyone accessing that illegal supply is at risk of a fatal overdose.  Yet, there are no true and documented stories of fentanyl contaminating cannabis. I could write a whole story about the failure of Canadian federal and provincial governments in their efforts to roll out legal cannabis, and why people are still going to the black market for their bud… but that’s not what this piece is about. It’s reasonable to suggest however that if you do care about your health the intelligent thing to do would be buying cannabis from a government source, as there are other things besides fentanyl that can be contaminating illegal weed.

How the media perpetuates the myth

So this myth? Fentanyl contaminating cannabis.  Why do so many people tell me this story? And then insist that they know it’s true because their cousin, nephew, friend was “just smoking weed” when he overdosed and died?  It’s a challenging one to confront.  The ones I’ve known that do tell these stories always stick with it and repeat it, they personally know someone whose death was told in this way.  They’re emotionally invested in the story.

This May 2019 Globe & Mail article out of Ontario, Canada tells this very story of “police investigating possible opioid-laced cannabis after teens overdose” and hints at the reason the myth persists.

The article tells us “Both victims were found unconscious with vomit around them and the stench of cannabis, he said. Officers quickly administered naloxone to both victims, Insp. Maher said, with one waking up right away and the other needing another dose of the antidote before both were transferred to hospital. Both teens were released on Wednesday night and police are now trying to find out whether they took other substances before the overdoses or whether the cannabis in a bong found at the scene was tainted with a powerful opioid, he said.”

There is no conclusion here, and the police are suspicious a substance was likely consumed besides the cannabis found in a bong.

This Globe article does a better job than most at objectively looking at the facts, they don’t allow people to draw conclusions and the investigators at the scene recognize that it’s most likely something else was being consumed.

“We’re going to do everything within our power to try to get some confirmation of what it was,” he said. “Teenagers obviously are going to be fairly tight-lipped about what happened.”

The myth people believe & the science behind its lie

People seem to believe that someone, somewhere is taking fentanyl and sprinkling it on cannabis and then selling it, is that right? Why? I guess the conclusion is the age old story of dealers trying to get people hooked.  Or maybe it isn’t quite that malicious, perhaps the idea is that the cannabis and the fentanyl were lying near to each other and somehow the fentanyl got onto the cannabis (cross-contamination).

Whichever way we arrive at the point where someone is smoking a joint (or bong) of ‘fentanyl laced cannabis’ the science of what’s happening is important.

Fentanyl vaporizes at very low temperatures (it’s why when it’s being smoked it’s generally done off tinfoil or a special pipe with a lighter a good distance away from it to prevent it from burning, the user wants to heat it up to a point that they can inhale the smoke which is around ~280 degrees Celsius.  By 500 degrees fentanyl is destroyed.  Gone.  It is not going to have a psychoactive effect or cause an overdose.  It’s burned up.  A flame is burning around ~2000 degrees, the cherry of a joint, or a lighter flame hitting a pipe is so hot it will destroy any fentanyl that may be present.

This is well understood by experts in toxicology, one such professional  is Ryan Marino MD from the division of medical toxicology, at the University of Pittsburgh school of medicine. Ryan built up a tremendous reputation online (@ryanmarino on twitter) debunking fentanyl myths with his #WTFentanyl campaign. Now we have some science.  But there are those who will still believe this CAN happen.  Has it???

While the stories continue to circulate research shows that the anecdotes don’t translate into conclusive data. 

This isn’t the first time this myth has been thoroughly debunked, so let’s get some quotes establishing the facts. 

From the BC Ministry of Health, May 7^th, 2018:
“Contrary to some reports, fentanyl has not been found in marijuana (cannabis)”

From the BC Minister of Public Safety and Solicitor General Mike Morris:
“I’d like to put a stop to the distraction from the deadly serious issue of our overdose crisis that has been taking place today, with regard to Premier Christy Clark’s comments that we had a confirmed case of marijuana laced with fentanyl. “As we’ve all heard from the Vancouver Police Department, this was reported in error, and we’ve also heard from the RCMP that the reports out of Masset earlier this week are also not confirmed.”

From the RCMP:
Asked directly whether local police have any evidence of fentanyl-laced pot on city streets, RCMP Cpl. Jodi Shelkie said no. “Kamloops RCMP does not have Health Canada verified results of recently seized marijuana to confirm if any was laced with any other drug,” she told KTW, while cautioning against the use of black-market weed.

From the Ontario Harm Reduction Network:
“Despite the discovery of a “product resembling cannabis” that was actually carfentanil, there are no documented cases of opioids being found in marijuana in Canada, according to the Ontario Harm Reduction Network (OHRN).”

The OHRN said in an information sheet that “it makes no sense” financially for dealers to cut cannabis, which carries a low profit margin, with opioids, which carry a high profit margin.  In addition, it would be “almost impossible” to add opioids to cannabis in amounts needed to create a physical dependency in users without causing an overdose, the OHRN said.

From the BC Center on Substance Use, the Globe & Mail & Vancouver Police:
M-J Milloy, an infectious-disease epidemiologist at the BC Centre on Substance Use, said it is concerning that the White House is repeating this “urban legend” in the midst of a continuing national public health emergency, especially since early research is showing cannabis may be a “gateway drug” to help people to wean themselves off deadly opioids.

“What we should be doing is trying to investigate and promote the use of cannabis as harm reduction rather than allow people to think that cannabis might be contaminated with fentanyl,” Dr. Milloy said.  He added that there is no incentive for cannabis dealers to add the drug to their products because it takes away from their bottom line.

“Typically drugs are cut to increase the value to traffickers, whereas cutting cannabis with fentanyl would reduce the [profit for] that cannabis: it would make it more expensive for them to produce,” he said.

The Vancouver Police, the Whitehouse & The Nark II field kit.

In 2015 The Vancouver Police made a mistake and claimed they’d found cannabis contaminated by fentanyl.  They put out a press release.  It was retracted: “Contacted last week, VPD Sergeant Jason Robillard said in an e-mailed statement that the department’s original claim was “an inaccuracy.” “The VPD has not come across marijuana laced with fentanyl,” he said.  After The Globe contacted the department, a correction was added to the middle of the online release that stated: “EDIT: The VPD has not come across marijuana laced with fentanyl – there was an inaccuracy in this news release, which we later corrected.”

The Trump Whitehouse even picked up on the mistaken VPD statement, albeit 4 years late without any due diligence they ran with it.  Kellyanne     Conway making the claim TWICE with an absurd statement that’s half lies half truth “Fentanyl is an instant killer and a tiny little grain of it can wipe us out – a little, little grain – and it’s being laced into marijuana, heroin, meth, cocaine and street drugs,”.
 
The word ‘laced’ is terrible.  It is used incorrectly constantly when we discuss substance contamination.  Laced implies intent.  It promotes the generally false narrative that people are propping up weaker drugs with stronger drugs to encourage use and accelerate the possibility of addiction.  For those that haven’t considered this; drugs are good enough on their own.  They don’t really need help in marketing. They don’t need slick advertising campaigns to sell. People use them because they feel good, and they pick their drugs based on preference.  It’s why some people like beer, some like wine, some like whisky, and others like cannabis or cocaine (or all of them!).  One thing is for sure, people prefer getting the drug they’re after and not some variation that’s been contaminated by another substance.  It’s why most heroin users prefer heroin over fentanyl.

A Sherriff’s field kit (The Nark 2) notorious for producing false positives in the wild, did exactly that with a routine traffic stop in New York revealing seized marijuana as testing positive for fentanyl.  The Sherriff (and the media) warned everyone.  Then the crime lab tested the cannabis properly and found no fentanyl whatsoever.  The Nark 2 field kit has been found to routinely produce false positives for fentanyl when tested on organic material and in fact there are at least twenty known substances that will produce a ‘fentanyl positive’ in the test.

The fact that our national leaders, law enforcement professionals & main stream media continue to perpetuate this myth is disheartening and only furthers fear. 

“It’s crazy that this story is coming out from our leaders,” epidemiologist Dan Ciccarone of the University of California, San Francisco, told BuzzFeed News. “It shows that concerns about fentanyl have reached the level of moral panic. Fear outweighs rational evidence. There is scant evidence for cannabis laced with fentanyl.” (original Buzzfeed News article)

So, what’s really driving this myth? STIGMA.

The story of weed laced with fentanyl is believable.  It plays on our worst fears.  It serves the fear based parent well as they can validate warning their children they could die if they smoke weed.  It serves the grieving family well as it reduces the social judgment they may experience if others found out the truth.

This myth helps us hide from the stigma of substance use.  I’ve heard this story told in many variations but the most common form is when family & loved ones tell others about an overdose that has happened. 

There is a hierarchy of stigma around substances in our society.  It goes like this “I only drink alcohol, at least I don’t smoke weed”.  The pot smoker says “I only smoke weed, at least I don’t do cocaine”.  The cocaine user says “I only do coke once in a while, at least I don’t smoke crack”.  The crack user says “at least I don’t do heroin”.  Obviously I’m being hyperbolic and tongue in cheek, but there’s truth in this analysis.

Our societies accept alcohol use, and increasingly cannabis is not stigmatized in the same way that other, illegal substances are.  People (in Canada and some US States) do not fear prosecution from cannabis possession any more.  When a first responder attends an overdose, people at the scene though protected by the good Samaritan law are nervous about the fact that there was illegal drug use happening.  “What happened here?” is likely to be asked by the authority and a reasonably safe response is “we were just smoking weed”.  Do you think individuals will risk the social judgment or criminal prosecution that could come with “we were doing coke, smoking heroin or snorting meth?”  That’s the story that stays hidden. The failed drug war and 75+ years of drug propaganda have created a culture in which we tend to treat people differently based on what substances they use.  It’s why I spent so much energy hiding my heroin addiction from co-workers, friends & loved ones.  We don’t throw pejoratives like junkie & druggie at people who smoke cannabis.  Sure the epithets pot-head and stoner are still with us, but those don’t create a mental image where we picture a homeless, drug injecting, criminal.  Yes, we reduce people in this way.  Single words, determining exactly what we think a person must be like.

Imagine being a parent.  Your child is struggling.  Their substance use is hidden but you’ve found signs and you’re worried.  A parent will do anything to help their child.  But the fear that somehow your own child’s drug use has something to do with your parenting is there in the back of your mind.  The awareness of the harsh way our society treats people with addictions. The desire to protect your child from the critical judgments of extended family, friends, strangers… Then one day, overdose.  You have a reputation to protect.  Your child has a reputation you want to protect.  Society is not kind.  They were just smoking weed… it must have had fentanyl in it.

And so the myth persists…

The family finds it easier to tell loved ones and friends that their child overdosed on contaminated cannabis… it’s certainly easier than being forthcoming about other harder substance use.

Or, perhaps the parents genuinely are naïve to the substance use, conceivably they were only aware of the cannabis use.

When post mortem toxicology reports are gathered they reveal the presence of all substances, not which substances were consumed in which order at what time.  Cannabis and fentanyl may show up, other drugs and adulterants are likely too. A tox report is inconclusive for generating a picture of what happened, at what time, in what order.

The bottom line here is the human toll.  This myth has been busted.  By experts.  The real issue is the driving force behind hurting families and friends that feel the need to hide.  The true root of what is going on in our culture that we can’t openly discuss drug use instead we have to make up stories to hide it.

It’s time to change the narrative.  It’s time to talk about overdose.  To open up, to be vulnerable.  To share the stories of our loved ones.

I have multiple friends who have died under suspicious circumstances.  With what I knew of them and know about the drug supply I have my unverified conclusions.  But the family won’t say.  They tell a story.  They hide.

Telling this lie amidst an ongoing overdose crisis is an egregious and harmful mistake.  Those who do are allowing a tired narrative of scare tactics to win, media outlets that publish this fear mongering are confusing the public at a time when all our collective energy should be focused on mitigating the harm of drug  use, reducing stigma and saving lives.